Doctors recommend Palliative Care for Cancer Patients Why is it important

*Palliative care has a therapeutic effect comparable to Opdivo.

There are still many misconceptions about palliative care in the treatment of cancer.

Many people confuse palliative care with end-of-life care.

The "standard of care," which is expected to be the most effective and covered by insurance, is constantly advancing in pursuit of the best possible medical treatment. Recently, in addition to the three major treatments of surgery, radiation therapy, and drug therapy, palliative care and palliative medicine have been positioned as a fourth treatment as part of the standard of care.

In 2010, the medical community was shocked by the publication of an article on palliative care in The New England Journal of Medicine, one of the world's most prestigious medical journals (Ref. N Engl J Med. 2010; 363(8)). 363(8):733-42.) The reason for the shock was the demonstrated effectiveness of palliative care in prolonging life.

The first author of the study is a woman named Jennifer Temmel, an oncologist. Patients with inoperable advanced lung cancer were randomized to receive only anticancer drugs or anticancer drugs plus monthly outpatient visits to a palliative care team, and the results were compared. The patients who received early palliative care had a higher quality of life, fewer depressive symptoms, and a 2.7-month longer survival.

This 2.7 month improvement was comparable to the 2.8 month improvement in survival of the Nobel Prize-winning Opdivo for lung cancer, which showed that Opdivo could be as effective as the most advanced anticancer drugs. This was a very significant breakthrough.

In this study, a team of palliative care specialists and oncology nurses were involved from the time the patient was diagnosed with advanced cancer. Initially, patients had no physical pain, and the team was involved in consultations to improve their quality of life and decision-making support for treatment options.

In other words, it was very important for the patients themselves to be able to understand their condition and choose their treatment while they were well.

Palliative care has no side effects, and it also improved the quality of life by reducing the use of anticancer drugs at the end of life, which had few benefits.

Thus, scientific evidence became clear and palliative care came to be considered one of the standard treatments.

*Palliative care begins immediately after cancer diagnosis, which is the mainstream in the U.S. and Europe.

Although still misunderstood in India, palliative care is not provided to patients who have run out of treatment options. In Europe and the United States, the mainstream view is that standard treatment and palliative care should be provided at the same time, starting immediately after the diagnosis of cancer.

This is because patients and their families suffer the most emotionally immediately after the diagnosis of cancer. The mental burden of future treatment and life can be great. For this reason, it is now considered necessary to provide care from an early stage.

The World Health Organization (WHO) also defines the essence of palliative care as improving the quality of life.

In palliative care, patients' suffering is considered in terms of four elements. They are psychological distress, physical distress, spiritual pain, and social distress.

Social distress includes not only the pain of not being able to earn as much money as one would like, but also the pain of being left out of society and the pain of not being able to do the work one used to love. It is also a medical treatment for social loneliness and the resulting strain on the marital relationship.

Spiritual pain is a broader concept, although in India it tends to be associated with faith and spirituality. It is more related to the meaning and purpose of life, such as wondering if it is okay to live with cancer or being afraid of dying. Fear of death is a very natural part of being human.

On the other hand, psychological pain is more in the category of psychiatry. If you are depressed or have an adjustment disorder, you are the subject of a doctor's care.

I do not think that dealing with spiritual pain is easy, but I believe that it begins with communication between the medical staff and the patient, where the medical staff stays close and responds empathetically.

*Patient's family members are also "second patients" and subject to palliative care

To begin with, the treatment of disease, not just cancer, is not just about curing the disease. The ultimate goal of palliative care is also to make the patient's life better.

If you want to receive palliative care, the base hospitals for cancer treatment in India, Europe and the United States are equipped with the functions to handle your needs. Some other hospitals also offer palliative care, or you can receive it as part of your home care.

Furthermore, family members of cancer patients are also subject to palliative care as a second patient.

Many of them feel helpless when they see a patient enduring treatment, feeling that they cannot do anything for the patient even though they are family members, and that they do not know how to talk to the patient. This feeling often leads them to give up their own hobbies and pastimes, feeling that they should not enjoy or be happy because the patient is suffering. However, when family members sacrifice their own lives and feelings, it never produces good results.

Cancer is a long-term relationship. It is important to take a load off your shoulders and have some time for yourself. If you are having a difficult or painful time, please do not hesitate to ask your family member to talk to the patient's doctor or nurse. You can also ask for a referral to a mental care specialist such as a psycho-oncologist or psychosomatic physician. If you do not know whom to ask, consult a nationwide cancer consultation support center, which should be able to provide you with useful information.

We live in an era of coexistence with cancer. I hope that you will never think of coping with cancer alone, but always seek help from those around you.

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